How much rates vary
Facilitymedian $2,692 · 10th to 90th $724 to $8,318Professionalmedian $1,148 · 10th to 90th $692 to $8,318
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,090.30 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $2,398.83 | Professional | None | $645.65 | $645.65 | $2,398.83 |
AllWays Health Partners Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $14,454.40 | Facility | None | $812.83 | $3,890.45 | $14,454.40 |
AllWays Health Partners Setting Professional Modifier None Typical Low $707.95 Median $1,659.59 Typical High $8,317.64 | Professional | None | $707.95 | $1,659.59 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,677.35 Typical High $7,079.46 | Facility | None | $741.31 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,778.28 | Professional | None | $912.01 | $912.01 | $1,778.28 |
Fallon Health Setting Facility Modifier None Typical Low $724.44 Median $912.01 Typical High $3,311.31 | Facility | None | $724.44 | $912.01 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,071.52 | Professional | None | $794.33 | $933.25 | $1,071.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $11,220.18 | Facility | None | $891.25 | $3,890.45 | $11,220.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,137.96 | Professional | None | $812.83 | $1,479.11 | $2,137.96 |
Mass General Brigham Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $14,454.40 | Facility | None | $812.83 | $3,890.45 | $14,454.40 |
Mass General Brigham Setting Professional Modifier None Typical Low $707.95 Median $1,659.59 Typical High $8,317.64 | Professional | None | $707.95 | $1,659.59 | $8,317.64 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,890.45 Typical High $16,595.87 | Facility | None | $1,071.52 | $3,890.45 | $16,595.87 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $3,090.30 | Professional | None | $851.14 | $1,122.02 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $1,071.52 | Facility | None | $512.86 | $707.95 | $1,071.52 |
Well Sense Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $812.83 | Professional | None | $602.56 | $602.56 | $812.83 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $1,202.26 | Professional | 52 · Reduced service | $323.59 | $323.59 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $478.63 | Professional | 53 · Discontinued | $128.82 | $128.82 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $1,819.70 | Professional | 54 · Surgery only | $489.78 | $489.78 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $363.08 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $239.88 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $1,698.24 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon + AS · PA/NP assist Typical Low $17.78 Median $23.99 Typical High $36.31 | Professional | 80 · Assistant surgeon + AS · PA/NP assist | $17.78 | $23.99 | $36.31 |
Where Massachusetts sits
The same service costs 7.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 16th of 51
$1,175
AK $2,884TX $398
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.